Few concepts in rhinoplasty engender as much discussion and conflict as the use of alloplasts in the nose. Clear divisions within the specialty have developed, with some surgeons using alloplastic implants liberally while others staunchly maintaining that alloplasts should never…
Over the past two decades, great improvements have been made in the design of facial implants. Facial implants are able to enhance facial contour and provide permanent volumetric replacement. Facial implants can be used in many anatomic regions of the…
Calvarial bone grafting is an established method of craniofacial reconstruction in facial plastic surgery. Konig and Muller were the first to describe autogenous calvarial bone grafting in 1890, advocating a combined osteocutaneous flap. Smith, Abramson, and Tessier popularized the technique…
The use of rib grafting in rhinoplasty has revolutionized the ability to treat complex nasal deformities. Its can be helpful for both primary nasal deformities (including posttraumatic, cocaine induced, and others), as well as secondary nasal deformities (including postoperative saddle…
Controlling the shape of the nasal tip can be one of the most challenging problems rhinoplasty surgeons face in practice. Prior to the advent of suture techniques, the cartilages of the nose were largely controlled, by excision, crushing, and scoring.…
One of the most important and difficult aspects of rhinoplasty surgery is creating a nicely shaped, natural-appearing nasal tip. This generally involves altering nasal tip definition, width, projection, and/or rotation. Nasal tip appearance is primarily determined by the shape and…
The importance of the middle third of the nose has been increasingly recognized in recent years. Reductive rhinoplasty techniques performed without regard for the structural integrity of this region can cause structural and functional compromise. In this chapter, the anatomy,…
General Principles Maintaining or achieving structural integrity of the nasal form is a formidable task in rhinoplasty and nasal reconstruction. Maintaining the form and function of the nose is an equally important objective as creating a pleasing aesthetic contour. In…
In 1898, Jacques Joseph was one of the first surgeons to promote the concept of the nasal osteotomy as a way to reshape and reposition the bony vault. The primary indications for osteotomies are to straighten a deviated nasal dorsum,…
The nationally reported revision rate for primary rhinoplasty ranges from 8% to 15%. Unfortunately, there will likely never be a shortage of patients requiring revision rhinoplasty. Experienced surgeons consistently achieve a high level of satisfaction among their patients. Still, complications…